Medicaid is a joint federal-state program that provides medical coverage to low-income individuals who are eligible. The goal of Medicaid in Texas is to enhance the health of persons in Texas who would otherwise be unable to afford medical treatment for themselves and their children. But what is traditional Medicaid in Texas? There are actually five different types of Medicaid in Texas: Traditional Medicaid, State of Texas Access Reform (STAR), STAR Kids, STAR Health, and STAR+PLUS. Read on to learn more about all Medicaid plans in Texas and traditional Medicaid benefits.
The STAR managed care program provides coverage to the majority of people in Texas who are eligible for Medicaid. STAR provides assistance to low-income families, pregnant women, and children.
Medicaid benefits available to members of the STAR program include:
STAR+PLUS is a Medicaid care program for adults 65 and above who have disabilities. Adults in STAR+PLUS are eligible for basic medical care and long-term services through a health plan of their choice. Those with complicated medical needs have the option of living and receiving care at home rather than in a nursing facility.
Long-term services include:
STAR Kids is a Medicaid program for children as well as adults who are 20 or below and have disabilities. Individuals under this program can get basic healthcare and long-term services through the network of the health plan’s provider.
Benefits provided by the program include:
When children are placed in foster care, they are frequently ineligible for traditional Medicaid coverage. This is when STAR Health enters the picture.
STAR Health provides Medicaid coverage for children through the Texas Department of Family and Protective Services. Services under STAR Health may include:
So, what is traditional Medicaid in texas? Traditional Medicaid, also known as Fee-for-Service (FFS), is for individuals who are enrolled in managed care. Under this system, bills are sent to the Texas Health & Human Services Commission (HHSC) and paid directly by Texas to providers enrolled with Medicaid.
Within traditional Medicaid benefits, the program pays for services such as clinic visits, vaccines and medicines, hospital care, emergency services, and more. For those with chronic health conditions or long-term disabilities, Medicaid also covers:
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